Study finds, Hemiretinal Asymmetry in Peripapillary Vessel D
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A Study was conducted to investigate the hemiretinal asymmetry in radial peripapillary capillary vessel area density (VAD) of healthy, glaucoma suspect, and glaucoma eyes of varying severity and its diagnostic utility for glaucoma.

6×6-mm optic disc scans were collected on optical coherence tomography angiography (OCTA) to obtain VAD and on OCT to measure circumpapillary retinal nerve fiber layer (RNFL) thickness. Hemiretinal difference in VAD (hdVAD) was defined as the absolute difference between superior and inferior hemiretinal VAD.

Age-adjusted multivariable linear regression of hdVAD on glaucoma severity was performed. Area under curves (AUCs) were calculated from predicted probabilities generated by multiple logistic regression of glaucoma severity on age-adjusted single and combined parameters.

--1043 eyes of 1043 participants (587 healthy, 270 suspect, 67 mild, 54 moderate, 65 severe glaucoma) were included.

--After age adjustment, mean hdVAD was similar between healthy and suspect, higher in mild versus suspect, higher in moderate versus mild, but lower in severe versus moderate.

--AUCs of hdVAD were highest for discriminating mild (0.685) and moderate (0.681) glaucoma from healthy.

--Combining hdVAD and global RNFL (gRNFL) yielded the highest AUCs of all parameters for mild (0.817) and any POAG (0.859) and resulted in significantly better diagnostic accuracy than either hdVAD or gRNFL alone.

Finally, hdVAD is higher in early glaucoma and may aid to detect damage in an early age when it is focused, but it seems less robust when it is diffuse in advanced glaucoma.